Risk factors for toxocariasis during incarceration: the One Health intervention approach

Despite potential exposure to soil-transmitted helminths, especially when stray dogs and cats are present, toxocariasis in inmate populations remains to be established. Accordingly, the present study assessed the seroprevalence and associated risk factors of toxocariasis at the Women's State Penitentiary of Parana, Brazil. A total of 234/370 (63.2%; 95% CI 58.2–68.0) women inmates and 28/87 (32.2%; 95% CI 23.3–42.6) correctional officers were seropositive for anti-Toxocara spp. IgG by ELISA, with inmates 2.62-fold more likely positive (p = 0.00000026). The univariate model has identified that non-white (OR = 1.58, p = 0.047) and older than 39 years (OR = 1.28, p = 0.032) inmates were associated with mild but significant odds for seropositivity. Elementary or higher educational level was considered a protective factor for seropositivity. The presence of Toxocara spp. eggs was observed in 10/15 (66.7%) collected soil samples by centrifuge-flotation in Zinc Sulfate, and molecular analysis by PCR identified only Toxocara cati in these eggs. An intervention program was established with regular trap-neuter-release, with gradual removal for adoption (donation campaigns), treatment, and euthanasia when necessary (particularly due to advanced sporotrichosis). In addition, an educational awareness agenda was proposed, aiming to reduce soil contamination and accidental intake by the incarcerated population. A total of 40 feral cats were trapped, 20 males and 20 females, mostly adults. After trapping, 36 cats were neutered, treated, and microchipped in the Veterinary Teaching Hospital (VTH) at the Federal University of Paraná. Five trapped feral cats were euthanized, four diagnosed with advanced sporotrichosis, and one already neutered cat (not herein) with complications due to feline immunodeficiency virus (FIV). Female inmates presented higher seroprevalence for Toxocara spp. antibodies when compared to correctional officers, significantly associated with age, self-declared ethnicity (non-white), and lack of formal education. Despite the non-natural scenario of a state penitentiary, the One Health approach of Toxocara spp. has highlighted the interdisciplinary nature of the study and its relevance in understanding the complex interactions between human, animal, and environmental factors, particularly impacting female inmates. Further studies should establish the rate of inmate infection over time while deprived of liberty.


TERMS OF FREE AND INFORMED CONSENT -Agents
We Prof. Alexander Welker Biondo (researcher in charge), Gabriel Luís Brucinski Pinto (Doctoral student) and from the Federal University of Paraná responsible for the research, as well as project participant Louise Bach Kmetiuk (Doctor), Juliano Ribeiro (Doctor), we are inviting you to participate in the studies entitled "Prevalence of anti-Toxoplasma gondii antibodies in a prison population and potential risk factors" and "Molecular and serological monitoring of SARS-CoV-2 in prisoners, prison guards and contacting cats of the Women's Penitentiary of Paraná".
a) The objective of this research is to evaluate the exposure of inmates, penitentiary agents and cats in contact with the Female Penitentiary of Paraná to SARS-CoV-2 through molecular detection.For this purpose, samples will be collected with swabs from the oropharynx/nasopharynx of detainees, employees and cats to verify the presence of the infectious agent.As well as to evaluate the prevalence of anti-T oxoplasma gondii antibodies in the occupants of the Piraquara Women's Penitentiary (PFP).To this end, blood samples from human and cat participants will be tested for toxoplasmosis.b) If you participate in the research, it will be necessary: I -We hold a brief conversation with the application of a questionnaire regarding SARS-CoV-2 (which causes COVID-19), the presence of clinical alterations, the presence of cats in the PFP, human-animal interaction and their personal hygiene habits.Which can take an average of 30 minutes.II -We will collect biological material (oropharyngeal content and blood) from you; c) To this end, nurses from the Municipal Health Department of Piraquara will collect blood, in the presence of the responsible researchers; d) It is possible that you experience some discomfort when the swab accesses the oropharynx/nasopharynx and especially with the prick of the needle for blood collection.If you are unable to bear the discomfort, the procedure will be stopped immediately.e) Some risks related to the study may occur, such as: possible discomfort due to the time required to complete the questionnaire and collect material, or even possible embarrassment due to the content of the questions.If you wish, the procedure will be interrupted immediately.
f) The direct benefits expected from this research are to reduce the risk factors of the prison population and employees for SARS-CoV-2 and toxoplasmosis.
g) The researchers Alexander Welker Biondo, Gabriel Luís Brucinski Pinto and Louise Bach Kmetiuk, responsible for this study, can be located respectively at Rua dos Trabalhadores, 1540, Juvevê, Curitiba-PR, Department of Veterinary Medicine, room meetings (2nd floor) and by calling 3350-5812; Biological Sciences Sector Department of Cellular Biology, Jardim das Américas -Curitiba -PR; Avenida Coronel Francisco Heráclito dos Santos, 210, for any questions you may have and to provide you with any information you may need, before, during or after the end of the study, from Monday to Friday from 8 am to 6 pm.Researchers may also be contacted via email address and telephone number.

i)
Information related to the study may be known by authorized persons: Prof. Alexander Welker Biondo and Gabriel Luís Brucinski Pinto.However, if any information is disclosed in a report or publication, this will be done in encrypted form, so that your identity is preserved and confidentiality is maintained.

j)
The material obtainedcontent of the oropharynx/nasopharynx and information from the questionnairewill be used solely for this research and will be destroyed/discarded at the end of the study, within 4 years.
k) The expenses necessary for carrying out the researchcollection material and examsare not your responsibility and you will not receive any cash value for your participation.
l) When the results are published, your name will not appear, but a code.

have read this Consent Form and understand the nature and purpose of the study in which I have agreed to participate. The explanation I received mentions the risks and benefits. I understand that I am free to discontinue my participation at any time without justifying my decision and without any prejudice to myself . I voluntarily agree to participate in this study.
If you have questions about your rights as a research participant, you can also contact the Ethics Committee for Research on Human Beings (CEP/SD) of the Health Sciences Sector of the Federal University of Paraná, by phone 3360-7259.The Research Ethics Committee is an independent multi and transdisciplinary collegiate body that exists in institutions that carry out research involving human beings in Brazil and was created with the aim of protecting research participants, in their integrity and dignity, and ensuring that researches are developed within ethical standards (Resolution nº 466/12 National Health Council). m)